Interpersonal Violence and Maxillofacial Fractures

The profile of patients with maxillofacial trauma due to interpersonal violence treated in a hospital emergency room

AIM

This study evaluated records of patients with maxillofacial trauma due to interpersonal violence (IPV) being treated in the emergency room of a level I trauma center hospital in São Paulo, Brazil.

MATERIAL AND METHODS

Data of patients with maxillofacial trauma due to IPV recorded between January 2019 and December 2019 were retrospectively examined. Personal data, days on which they experienced IPV, and the type of maxillofacial trauma sustained were extracted and statistically analyzed (p < .050).

RESULTS

During the analysis, 1034 patients with maxillofacial trauma were identified; of these patients, 292 (28.2%) who experienced trauma due to IPV were included in this study. There was a mean age of 32.6 years and the most common type of trauma was soft tissue injuries (38.7%). Mandible and nose fractures were more prevalent in males and females, respectively. Our data, when compared with other studies on maxillofacial trauma due to IPV, showed a lower prevalence and male-to-female ratio, and a higher presence of dentoalveolar trauma. Additionally, our data when compared with studies on maxillofacial trauma due to other causes showed lower mean age and male-to-female ratios, and a higher occurrence of nose fractures differing from the predominance of mandibular fractures.

CONCLUSION

Oral and maxillofacial surgeons must be able to suspect and identify cases due to IPV among their patients with trauma. With our results, although each case has its individuality, we can suggest that cases of maxillofacial trauma in young, female, and nasal fracture patients may be suspicious for IPV.

Characteristics of Associated Injuries in Children and Teenagers With Craniofacial Fractures

The incidence of pediatric craniofacial fractures and heterogeneity of fractures is known to increase with age. This study aimed to determine the occurrence of associated injuries (AIs) to craniofacial fractures and identify differences in patterns of and predictors for AIs in children and teenagers. A 6-year retrospective cross-sectional cohort study was designed and implemented. The study population included 397 patients aged 19 years or less diagnosed with craniofacial fracture at Helsinki University Hospital from 2013 to 2018. Boys (71.0%) and teenagers (64.7%) were predominated. Associated injuries were more common in teenagers than children. Teenagers had more often AI in 2 or more organ systems. Assault and intoxication by alcohol were observed only in teenagers and predominantly boys. A total of 27.0% of all patients sustained AIs. In 18.1%, brain injury was reported. In children, motor vehicle accident (MVA) was an independent predictor for AI. In teenagers, independent predictors for AI were female sex, isolated cranial fracture, combined cranial fracture, and high-energy trauma mechanism. Injury patterns and AI related to craniofacial fractures in the pediatric population are age-specific, requiring multidisciplinary collaboration in the diagnosis, treatment, and follow-up of such trauma. Predictors for AIs increase in complexity with age, and the role of sex as a predictor is evident in teenagers.

The Effect of Covid-19-Related Social Distancing Restrictions on Maxillofacial Fractures Epidemiology

Background

The purpose of the present study was to evaluate the changes in maxillofacial fracture epidemiology and etiology regarding Covid-19-related social distancing restrictions in an Iranian population.

Methods

A retrospective cross-sectional study was undertaken in six major trauma center hospitals in Iran in a period of two years (March 2018 until March 2020). The primary outcome variable was the maxillofacial fractures incidence. Patients' demographic data, date of injury as well as fracture characteristics, fracture etiology, type, and site were all recorded, compared, and analyzed in the control and experimental groups.

Results

The patients consisted of 520 (83.6%) males and 102 (16.4%) females. Patients sustaining maxillofacial fractures over this two-year period displayed a mean age of 31.24±14.44, with an age range of 2 to 88 years. The incidence of maxillofacial fractures significantly decreased in all age groups (p<0.001). After social distancing restrictions were placed; there was a significant drop in the number of subjects attending due to motorcycle collisions and road traffic accidents, whereas the number of fractures caused by assaults and domestic violence significantly increased (p<0.001 for each).

Conclusion

The investigators realized that social distancing restrictions were able to change the trends and patterns in maxillofacial fracture incidence and etiology.

Head and Face Injuries in Brazilian Homicide Victims - A Retrospective Study

Introduction:

Violence is a serious problem in view of its magnitude and impact on the health of the population in several countries. The aim of the study was to evaluate the occurrence of head and face injuries among homicide victims in a municipality in the Northeastern region of Brazil.

Materials and Methods:

A cross-sectional study carried out at the Police Station for Crimes against Persons of the Civil Police, which evaluated 168 police inquiries of homicide victims notified from January 2015 to December 2018. Variables analyzed were related to the Victim's sociodemographic profile, homicide characteristics and body region involved. Descriptive data analysis and Pearson's Chi-square test (P < 0.05) were performed.

Results:

There was greater involvement of men (92.9%) aged 20–29 years (36.3%), drug users (70.7%) and with a criminal record (65.9%). There was a predominance of simple homicides (92.3%), with greater occurrence on Sundays (16.7%), in the night shift (40.1%), revenge was the main reason for the crime (32%), and firearms as the main means used (89.2%). Regarding the number of body regions affected, victims were more frequently affected in 2 regions (36.5%). Head injuries were identified in 68.3% of victims, while face injuries represented 35.3%. There was an association between the presence of head injuries and number of injuries (P < 0.05).

Discussion:

The prevalence of head and face injuries resulting from homicide was high and victims are predominantly young men, drug users and those with a criminal record. The association was found between the presence of head injuries and number of injuries.